MASC POLICY BOOK
COMAR Resolutions up to2015
Contents
Pay parity…………………………………………………………………………………3
Pay and Pensions...... 3
Contracts (general)……………………………………………………………………....3
Contracts (consultants)...... 4
Contracts (Junior)………………………………………………………………………...5
Job planning……………………………………………………………………………....6
Disciplinary arrangements………………………………………………………………..6
Regulation, Revalidation and Appraisal...... 6
Research Integrity and Ethics...... 7
Academic training and careers……………………………………………………………8
Funding of medical education…………………………………………………………….10
Medical education...... 11
Medical training…………………………………………………………………………………………………… 13
Shape of Training Review…………………………………………………………………………………. 13
Medical School selection and entry………………………………………………………13
Medical Students...... 14
Research……………………………………………………………………………………14
NHS structure………………………………………………………………………………15
Equality issues and women in academic medicine…………………………………...... 17
Trade union recognition……………………………………………………………….....18
MASC and BMA…………………………………………………………………………...18
MASC Constitution...... 20
Devolved Nations...... 20
COMAR Constitution...... 20
Miscellaneous...... 20
Pay parity
1.That this Conference re-asserts the importance of continued pay parity between NHS medical staff and clinical academic counterparts as the minimum remunerative standard necessary to promote recruitment and retention of clinical academic teaching and research staff. (2005)
Pay and Pensions
2.That this Conference notes that
i)Medical academics are not able to take part in industrial action for legal reasons;
ii)This does not mean that academic doctors are not equally angered by the government action on pensions.
Conference declares that:
i)it is fully supportive of any action sanctioned by BMA Council that is taken to highlight and change this situation;
ii)although it is anticipated that academic doctors will be working normally during any industrial action, it is not contemplated that they will be working additionally on a voluntary basis to cover any gaps in service created by the industrial action. (2012)
3.That this conference notes that on-call clinical service provision within the NHS is recognised and rewarded whereas corresponding performance, in terms of training / educational attainment as well as unsocial hours worked, within the government-funded HEI sector is entirely ignored. This has a demoralising effect on clinical-academic trainees while also acting as a significant financial disincentive to enter this career path. We call on the BMA to work with all relevant stakeholders in exploring ways to address this injustice. (2012)
Contracts (general)
4.That this conference welcomes the clarity that should be brought about by the all-Wales honorary NHS contracts for medical academics due to be agreed between the BMA, the university employers and the NHS in Wales. Conference notes that the contracts should ensure parity of pay (including access to commitment and clinical excellence awards) with colleagues in the NHS whilst providing sufficient flexibility for academics to enable them to carry out their research and teaching functions and making it clear on what constitutes work for the benefit of the NHS. (2013)
5.That this Conference notes the ongoing discussions on both the consultant and junior doctors contracts, and asks that MASC reports back to the medical academic community on developments on both contracts. (2013)
6.That this conference calls on the BMA to ensure a satisfactory resolution to the current issue of the organisation that should hold the honorary contracts of academic doctors working in public health and requests that the MASC continues to work to support public health academics who wish to continue to undertake research related to the NHS to ensure they are not disadvantaged by any new contractual arrangements that might arise in the future. Conference believes that future contracts, whether held by Public Health England or another body, should offer public health academics the same terms and conditions as currently prevail in the NHS. (2013)
7.That this conference notes the recent problems with transitional arrangements for transferring clinical academic honorary contracts that were with Primary Care Trusts (PCTs) to other NHS organisations in time for the changes on 1st April 2013. Conference further notes that this caused concern for the staff concerned, and that many had no clear solution for the arrangements which would apply after the PCTs ceased to exist whilst new arrangements were negotiated, which may have left them unable to undertake research within the NHS until new contracts were negotiated and signed.
Whilst Conference welcomes the resolution to this issue that has now been proposed by the NHS Commissioning Board, conference proposes that an arrangement be agreed between MASC and senior staff within NHS England and the Department of Health for dialogue and discussion on such matters, to facilitate future discussions in a timely and planned manner, and to coordinate responses amongst key stake-holders, whilst ensuring that academic issues and interests remain high priorities through the NHS changes. (2013)
8.That this Conference, noting the effectiveness of the Clinical Excellence Award (CEA) schemes in supporting and encouraging contributions by consultants and clinical academics to innovation, education and research in the NHS and the development and improvement of quality and safety of patient care:
i)deplores the reduction in funding of the national and employer-based schemes without consultation or negotiation;
ii)believes that the abolition of CEAs would lead to demotivation among consultants and clinical academics and loss of innovation and leadership while achieving only relatively small savings;
iii)believes that the review of CEAs should ensure they remain fit for purpose and relevant. (2011)
9.That this meeting deplores the lack of reciprocity between NHS and University contracts, and the way in which this dissuades trainees from starting an academic career and calls upon the BMA to ensure that medical academics are contractually accorded the same rights to continuity of employment and redundancy as their counterparts in the NHS thus achieving a long held principle of parity. (2010)
10.AS A REFERENCE: That this meeting deplores the practice of universities that are using the new consultant contract to introduce performance related pay, as this is against the terms of the contract. (2005)
11.That this Conference notes with concern that during transfer of clinical academic staff from the old to the new contract it has been suggested that some Universities are intending to reduce the leave requirement from six weeks to four weeks per annum, and therefore instructs the incoming MASC Executive to ensure that this type of change in conditions of service is not introduced via a back door route. (2005)
12.That this conference notes that doctors with caring responsibilities often require flexible and individualized working patterns. We also note this in the context of longer working life spans, with later retirement age. Conference believes that:
(i)flexible and individualized working arrangements should be used to support doctors with caring responsibilities
(ii)caring responsibilities should never be a bar to continuing with an academic career and that less than full time posts should be fully supported.
Conference therefore calls for
(i) Organisers of research projects to consider whether tasks could be job-shared;
(ii) Those with responsibility for funding or directing research to consider whether project life-spans could be extended so that they do not exclude researchers who wish to work less than full time;
Greater investment by universities in technology that supports working from home and decreases the need for travel by enabling virtual meetings and collaboration;
The BMA to campaign for more flexible working arrangements for doctors in all sectors. (2014)
Contracts (Consultants)
13.That this conference believes that clinical academics holding NHS honorary consultant contracts should continue to have access to any future local and national award schemes alongside NHS consultants and it therefore instructs the relevant BMA committee(s) to set this as a priority area in any negotiation and, in particular, for MASC to press for a fair outcome for medical academics under the proposals. (2013)
14.(As a reference) ThatthisMeetinginsiststhattheconsultantcontractmustretainthe rightofallconsultantstopublishindependentlyresearch,auditandreviewsofclinicalservices. (2013)
15.That this conference welcomes the statement in the consultant contract negotiations recognising the significance of educational, training, research and innovation activities as key components of medical professionalism and that all partners are committed to ensuring that such activities will not be adversely affected by changes which may be introduced into the consultant contract as a result of these negotiations.
Conference, therefore,
(i)Endorses BMA resistance to pressures by any employers on consultants (including clinical academics) to reduce access to SPAs, in view of the adverse medium to long-term impact on the quality of care patients receive which any such reduction would have.
(ii)Calls on the BMA to ensure that the measures of activity by all doctors should include not only “quality of patient care and patient feedback” but also their role in education, training and research. (2014)
16.That this conference:
(i)Believes that a successful negotiation can only be achieved if the terms Emergency, Urgent and Elective care are clearly defined and agreed by all parties to the negotiations;
(ii)Believes that any attempt to erode doctors pay increments and CEAs in addition to real term salary reduction will be hugely demotivating to the medical workforce;
(iii)Insists that Consultants must have the right to remain on their existing terms and conditions of service regardless of the outcome of the current, or future, contract negotiations;
(iv)Believes that national Terms and Conditions of Service must be maintained. (2014)
17.That this conference believes that an outcome of the contract negotiations should be appropriate and robust safeguards to protect clinicians from the deleterious health effects of night shift working (2014)
18.That this conference notes the effectiveness of the clinical excellence award schemes in supporting and encouraging contributions by consultants to education, research and innovation and the development of quality and safe patient care, and:
(i)believes the abolition of the CEAs would lead to demotivation and loss of medical leadership;
(ii)insists that any new scheme should remain fit for purpose;
(iii)demands that the funding must remain part of the overall remuneration package;
(iv)calls upon the BMA to consider fairer more transparent processes.
19.This conference calls upon the BMA to assess how the consultant 7 day working week will shape medical student clinical education and decide whether policies need to be put in place to protect student welfare. (2014)
Contracts (Junior)
20.That this conference recognises the vital importance of education and training for junior doctors and the changes to the structures of postgraduate education and training. Conference notes the lack of formalised job and training planning for clinical academic trainees, and the reliance solely on ad-hoc meetings for such planning. Conference, therefore, calls on employers as part of contract negotiations to:
(i)Enshrine a formal requirement for six monthly job and training planning meetings in the new contract;
(ii)Provide clinical academic trainees with a training plan that integrates their clinical training with their research commitments in a structured way;
(iii)Allow them to complete their clinical training based on competencies acquired, rather than time served in post.
(iv)Provide a minimum, non-discretionary study leave allowance of 20 days for all doctors in training, with 10 additional discretionary days available if required;
(v)Ring-fence and protect the study leave budget, ensure each trainee is aware of their budget and work with Local Education and Training Boards and other relevant bodies to ensure that this is equitable across different areas of the country. (2013)
21.That conference is concerned at the significant drop in salary experienced by most clinical academic trainees when transferring from a full time clinical post. It notes that this is due to reduction of banding and associated payments on transfer to an academic post, the longer duration of training and the time taken out of programme to undertake a research degree. We call on the employers, as part of contract negotiations to fully recognise the role junior clinical academics play in carrying out high quality research by:
(i)Providing full pay parity (including matching of on-call supplements) for clinical academic trainees in any future contract;
(ii)Providing specific additional remuneration for trainees with a higher degree, as seen in the Agenda for Change contracts;
(ii)Extending the pay scale for academic clinical trainees with additional points at the top of the scale to reflect the longer time spent in training. (2013)
22.That this conference notes the proposals relating to the potential movement of the point of full registration of UK medical graduates to align with the point of graduation. It expresses concern that the financial and contractual issues have not yet been clearly articulated by the employers, particularly that fully registered doctors can rightly expect to be paid accordingly and not at rates currently paid to pre-registration doctors. Conference calls on the BMA to ensure this issue is highlighted in contractual discussions with the employers. (2014)
23.That this conference understands that any future contract for juniors will not be approved by the Treasury unless automatic annual pay-progression is removed. If this provision were to be lost, we demand:
That any cost savings be ploughed back into the basic salary scale of doctors in training;
JDC negotiators to minimise absolutely the number of doctors who do not get increments at appropriate gateways;
Dispensation for those who undertake Deanery/LETB approved out-of programme to ensure an academic career in medicine does not become even less attractive;
A workaround to ensure that doctors who take maternity/paternity/caring leave or have to work less than full time are not disproportionately affected. (2014)
Job planning
24.This conference re-iterates that the new clinical academic contract is a time-based contract and is concerned at attempts by some institutions to award programmed activities on the basis of performance (2006)
25.This meeting believes that any consultant job plan (new or review) for clinical academics should ensure that adequate supporting professional activities are allocated, and that external duties are acknowledged as being separate from study or professional leave. (2006)
26.That this conference:
i)emphasizes the principle of joint assessment of job plan and appraisal by Trust and Academic Institution for medical academics
ii)demands that the actual level of Programmed Activity undertaken by the employee, including additional PAs, should be recognized by the Academic Institution as well as the Trust
iii)demands that additional PA of academic time must be remunerated in full by the Academic Institution, in addition to full remuneration by the Trust concerned for additional service-related PA. (2005)
27.That this conference welcomes job planning on an individual basis for the honorary NHS contract but the conference abhors any attempts by the employers to unilaterally increase the NHS workload at the expense of teaching and research (2005)
Disciplinary arrangements
28.That this Meeting strongly supports the principle of whistle-blowing by members of the medical profession in their workplace when the safety of patients are at risk, as highlighted in the Francis Report, thereby totally supporting the action of such whistle-blowers concerned, instead of punishing them.
29.That this conference applauds the recognition by the NHS employers that they will be responsible for discipline in clinical matters and not the University employers (2005)
Regulation, Revalidation and Appraisal
30.That this conference believes that the Medical Research Council (MRC):
(i)terms of employment for medical qualified staff ought to be in line with nationally agreed terms and conditions for medical academic staff
(ii)needs to provide clear guidelines and support for the revalidation of medically qualified staff employed directly by the MRC. (2013)
31.That this Conference is concerned at the:
i)slow progress in developing and agreeing an appropriate revalidation process for clinical academics; and
ii)lack of any initial guidance on how medical academics without a clinical contract but who wish to retain a licence to practice will revalidate.
Conference calls on:
i)the Department of Health, through its Revalidation Support Team, to ensure that revalidation for clinical academics is based on a Follett-compliant joint appraisal process and that this process is supported by a model appraisal form that facilitates such a joint discussion by having a specific section on education, training and research.
ii)the GMC to clarify with the BMA how those medical academics who wish to be revalidated will be, including who will take on the Responsible Officer function for this group of doctors should the RO responsible for their clinical academic colleagues at the same higher education institution be unwilling to do so.
iii)the BMA and branch of practice committees not to agree the start of revalidation UNTIL remediation is available to all doctors on an equal basis. (2012)
32.AS A REFERENCE: That this conference deplores the massive super-inflationary increase in training fees recently announced by the Joint Royal Colleges Postgraduate Training Board (JRCPTB) and the Royal College of Obstetrics and Gynaecology (RCOG), coming as they do in the midst of the worst economic crisis in a generation and appearing to ignore the alary stagnation trainee doctors have suffered in real terms in recent years. We call on the:
i)Royal Colleges to reconsider this decision and to publish in full their budgets for 2010-2011, showing what efficiency savings are planned to help curb the spiralling cost of postgraduate medical training; and
ii)BMA to lobby to this end. (2010)
33.That conference would like to resist any measure taken by medical Royal Colleges to use revalidation:
i)As an excuse to introduce yet more exams;
ii)To set unrealistic quality benchmarks for revalidation. (2010)
34.Thatthis Conference notes with dismay the tendency for HEIs and Health Boards in Wales to conduct separate appraisals for clinical academics. Conference notes that the failure to undertake genuinely joint appraisal and job planning processes risks VAT being charged in services provided by clinical academics. Conference believes that academic jobs should be integrated so that academic research, teaching and management mesh with clinical activities.